Business Ownership*

Owner / Officers / Partners

This information may be used to check the personal credit of individuals listed.

Name

Social Security Number

Title

Ownership Percentage

Home Street Address

City

State

ZIP Code

Home Phone

Home Ownership

OwnRent

Birth Date

Driver's License Number

Name

Social Security Number

Title

Ownership Percentage

Home Street Address

City

State

ZIP Code

Home Phone

Home Ownership

OwnRent

Birth Date

Driver's License Number

Bank Information

Bank Name

City

State

Phone

Checking Account #

Date Opened

Terms and Conditions

I (we) certify that the above information is complete and correct and the equipment is being acquired for commercial and not consumer use.

I (we) authorize the bank listed above to provide credit information to Advance Acceptance. I (we) understand that Advance Acceptance may use the provided information to check personal credit of owners, officers or partners indicated above.

Financial statements may be required based on credit and/or transaction size.

When you apply for an account with us, we will ask for your name, address, date of birth and other information that will allow us to identify you. We will ask to see your driver’s license or other identifying documents.